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Overview of carpal fractures

Kevin deWeber, MD, FAAFP, FACSM
Section Editor
Patrice Eiff, MD
Deputy Editor
Jonathan Grayzel, MD, FAAEM


Upper extremity fractures are among the most common of limb injuries; carpal fractures account for 18 percent of hand fractures and 6 percent of all fractures [1]. Fractures to bones of the proximal carpal row are most frequent. Scaphoid fractures are by far the most common of the carpal fractures, and account for 10 percent of all hand fractures and 60 to 70 percent of all carpal fractures [2]. The incidence of fracture of the remaining bones is small, being on the order of 0.2 to 5 percent. In general, carpal fractures occur from either direct or indirect trauma. (See "Scaphoid fractures".)

Splinting is used in the initial immobilization of carpal fractures. A detailed description of the techniques for applying splints is presented separately. (See "Splinting of musculoskeletal injuries".)

This topic provides an overview of basic carpal anatomy, mechanisms of injury, general principals of examination and imaging, and the initial care of adults with carpal fractures. More detailed discussions of common and important wrist injuries are presented separately. (See "Evaluation of the adult with subacute or chronic wrist pain" and "Distal radius fractures in adults" and "Scaphoid fractures" and "Lunate fractures".)


Carpal fractures are classified primarily by the anatomic location of the fracture (see 'Anatomy' below) and secondarily based upon the features of the injury, including associated displacement, dislocation, and the number of fragments produced by the fracture (comminuted versus noncomminuted). Isolated fractures through the distal radius or ulna, although described in lay terms as "wrist fractures," do not involve the carpal bones. (See "General principles of fracture management: Bone healing and fracture description".)

Brief description of fractures — Issues related to fractures of the eight carpal bones (image 1) are discussed separately in the appropriate topic reviews that are listed below:


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Literature review current through: Sep 2016. | This topic last updated: Oct 1, 2015.
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